Provider Demographics
NPI:1083088702
Name:GLASGOW MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:GLASGOW MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:KRETZ
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:302-836-8350
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4777
Mailing Address - Country:US
Mailing Address - Phone:302-836-8350
Mailing Address - Fax:302-836-1906
Practice Address - Street 1:550 S COLLEGE AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-553-7148
Practice Address - Fax:302-861-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2015603017261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care